The ALS Association Greater New York Chapter Volunteer Form

Thank you for your interest in volunteering for The ALS Association Greater New York Chapter. By filling in the information below, we will be able to find a suitable role for you to play within our chapter. If you have any questions problems with this form, please contact Vivian Jung.

1.

*=Required

Title:

Required

*

First Name: Required

*

Last Name: Required

Email:

*

Street 1: Required

Street 2:

*

City: Required

*

State / Province: Required

Required

*

ZIP: Required

*

Phone Number: Required

Yes, I would like to receive e-mail from The ALS Association Greater New York Chapter

2.

Question - Not Required -
Work Phone:

*3.

Question - Required -
Preferred contact method:

EmailHome PhoneWork Phone

*4.

Question - Required -
What type of volunteering would you be interested and able to do?Please make at least 1 selection from the choices below.

Fund Raising/Events

Symposium/Educational Events

Home Visits in New York

Home Visits in New Jersey

Walk to Defeat ALS

Please contact us at (212) 619-1400 if you do not receive any communications about volunteering. Thank you.